Remdesivir Decreases Mortality in COVID-19 Patients with Active Malignancy
Jerzy Jaroszewicz, Justyna Kowalska, Małgorzata Pawłowska, Magdalena Rogalska, Dorota Zarębska‐Michaluk, Marta Rorat, Beata Lorenc, Piotr Czupryna, Katarzyna Sikorska, Anna Piekarska, Anna Dworzańska, Izabela Załęska, Włodzimierz Mazur, Dorota Kozielewicz, Kajetan Klos, Regina Podlasin, Grzegorz Angielski, Barbara Oczko-Grzesik, Magdalena Figlerowicz, Bartosz Szetela, Beata Bolewska, Paulina Frańczak-Chmura, Robert Flisiak, Krzysztof Tomasiewicz
Abstract
Data on the use of remdesivir, the first antiviral agent against SARS-CoV-2, are limited in oncologic patients. We aimed to analyze contributing factors for mortality in patients with malignancies in the real-world CSOVID-19 study. In total, 222 patients with active oncological disorders were selected from a nationwide COVID-19 study of 4890 subjects. The main endpoint of the current study was the 28-day in-hospital mortality. Approximately half of the patients were male, and the majority had multimorbidity (69.8%), with a median age of 70 years. Baseline SpO2 < 85% was observed in 25%. Overall, 59 (26.6%) patients died before day 28 of hospitalization: 29% due to hematological, and 20% due to other forms of cancers. The only factor increasing the odds of death in the multivariable model was eGFR < 60 mL/min/m2 (4.621, p = 0.02), whereas SpO2 decreased the odds of death at baseline (0.479 per 5%, p = 0.002) and the use of remdesivir (0.425, p = 0.03). This study shows that patients with COVID-19 and malignancy benefit from early remdesivir therapy, resulting in a decrease in early mortality by 80%. The prognosis was worsened by low glomerular filtration rate and low peripheral oxygen saturation at baseline underlying the role of kidney protection and early hospitalization.